Effect of different tube feeding methods on gastroesophageal reflux features in preterm infants: a pH-impedance monitoring study.
Bolus tube feeding
Continuous tube feeding
Gastroesophageal reflux
PH and multiple intraluminal impedance monitoring
Preterm infants
Journal
European journal of pediatrics
ISSN: 1432-1076
Titre abrégé: Eur J Pediatr
Pays: Germany
ID NLM: 7603873
Informations de publication
Date de publication:
30 Aug 2024
30 Aug 2024
Historique:
received:
04
02
2024
accepted:
17
08
2024
revised:
13
08
2024
medline:
31
8
2024
pubmed:
31
8
2024
entrez:
30
8
2024
Statut:
aheadofprint
Résumé
A stepwise approach is currently considered the best choice to manage gastroesophageal reflux (GER) in preterm infants. This study aimed to evaluate the effect of different tube feeding techniques on GER frequency and features in symptomatic tube-fed preterm neonates. Tube-fed infants < 34 weeks' gestation were eligible for this prospective, bicentric, cross-over study if, due to GER symptoms, they underwent a diagnostic 24-h combined pH and multiple intraluminal impedance (pH-MII) monitoring. During the monitoring period, each infant received the same feeding cycle, repeated twice: continuous tube feeding, bolus feeding followed by tube feeding permanence and by tube feeding removal. The impact of these three feeding modalities on pH-MII GER features was assessed. Thirty-one infants were enrolled. Despite a low number of reflux episodes, a significant decrease in total GERs (P < 0.001), in GERs detected by pH monitoring (P < 0.001), and in both acid and non-acid GERs detected by MII (P < 0.001 and P = 0.009, respectively) was observed in association with continuous feeding compared to bolus feeds, followed or not by tube feeding removal. Compared to continuous feeding, both bolus feeding modalities were associated with a significantly higher number of proximal GERs (P < 0.001). No difference in any pH-MII parameter was observed in relation to tube feeding persistence after bolus feeding administration. Continuous feeding and boluses may have a different impact on pH-MII GER features in symptomatic tube-fed preterm infants, whereas the permanence of the feeding tube across LES did not seem to worsen GER indexes. • Due to the functional and anatomical immaturity of the gastrointestinal tract, gastroesophageal reflux (GER) is common in preterm infants. • A stepwise therapeutical approach which firstly undertakes conservative strategies is the most advisable choice to avoid potentially harmful pharmacological overtreatments in the preterm population. • Continuous feeding and boluses may have a different impact on GER features assessed by pH-MII monitoring in tube-fed preterm infants. • The permanence of the feeding tube during or after the feeding period did not seem to worsen GER occurrence. • By reducing GER features, especially acid GER, continuous feeding may potentially contribute to limit the need for antiacid medications in this population.
Identifiants
pubmed: 39212753
doi: 10.1007/s00431-024-05737-7
pii: 10.1007/s00431-024-05737-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s).
Références
Quitadamo P et al (2019) Esophageal pH-impedance monitoring in children: position paper on indications, methodology and interpretation by the SIGENP working group. Dig Liver Dis 51:1522–1536
doi: 10.1016/j.dld.2019.07.016
pubmed: 31526716
Binti Abdul Hamid H, Szatkowski L, Budge H, Ojha S (2022) Anti-reflux medication use in preterm infants. Pediatr Res 92:520–5
doi: 10.1038/s41390-021-01821-y
pubmed: 34716422
Terrin G et al (2012) Ranitidine is associated with infections, necrotizing enterocolitis, and fatal outcome in newborns. Pediatrics 129:e40–e45
doi: 10.1542/peds.2011-0796
pubmed: 22157140
Manzoni P et al (2018) Exposure to gastric acid inhibitors increases the risk of infection in preterm very low birth weight infants but concomitant administration of lactoferrin counteracts this effect. J Pediatr 193:62–7.e1
doi: 10.1016/j.jpeds.2017.09.080
pubmed: 29198543
Eichenwald EC, NEWBORN COFA (2018) Diagnosis and management of gastroesophageal reflux in preterm infants. Pediatrics 142(1):e20181061
Corvaglia L, Martini S, Aceti A, Arcuri S, Rossini R, Faldella G (2013) Nonpharmacological management of gastroesophageal reflux in preterm infants. Biomed Res Int 2013:141967
Rommel N, van Wijk M, Boets B, Hebbard G, Haslam R, Davidson G, Omari T (2011) Development of pharyngo-esophageal physiology during swallowing in the preterm infant. Neurogastroenterol Motil 23(10):e401–8
Richards R, Foster JP, Psaila K (2021) Continuous versus bolus intermittent intragastric tube feeding for preterm and low birth weight infants with gastro-oesophageal reflux disease. Cochrane Database Syst Rev 6;8(8):CD009719
pubmed: 34355390
Corvaglia L, Mariani E, Aceti A, Capretti MG, Ancora G, Faldella G (2009) Combined oesophageal impedance-pH monitoring in preterm newborn: comparison of two options for layout analysis. Neurogastroenterol Motil 21(10):1027–e81
Corvaglia L, Martini S, Corrado MF, Mariani E, Legnani E, Bosi I, Faldella G (2016) Aceti, A. Does the Use of Pacifier Affect Gastro-Esophageal Reflux in Preterm Infants? J Pediatr 172:205–8
Ibrahim NR, Kheng TH, Nasir A, Ramli N, Foo JLK, Syed Alwi SH, Van Rostenberghe H (2017) Two-hourly versus 3-hourly feeding for very low birthweight infants: a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 102(3):F225–F229
Favara MT, Abraham S, DiPalma J, Epstein M, Greenspan JS, Aghai ZH (2020) Prolonging gavage feeds for reduction of gastroesophageal reflux in infants. J Perinatol 40(6):916–921
Murthy SV, Funderburk A, Abraham S, Epstein M, DiPalma J, Aghai ZH (2018) Nasogastric Feeding Tubes May Not Contribute to Gastroesophageal Reflux in Preterm Infants. Am J Perinatol 35(7):643–647
Omari TI, Barnett CP, Benninga MA, Lontis R, Goodchild L, Haslam RR, Dent J, Davidson GP (2002) Mechanisms of gastro-oesophageal reflux in preterm and term infants with reflux disease. Gut 51(4):475–9
doi: 10.1136/gut.51.4.475
pubmed: 12235066
pmcid: 1773397
Argon M, Duygun U, Daglioz G, Omür O, Demir E, Aydogdu S (2006) Relationship between gastric emptying and gastroesophageal reflux in infants and children. Clin Nucl Med 31(5):262–5
doi: 10.1097/01.rlu.0000210500.64440.76
pubmed: 16622332
Rosen R et al (2018) Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr 66(3):516–554
doi: 10.1097/MPG.0000000000001889
pubmed: 29470322
pmcid: 5958910
Aynsley-Green A, Adrian TE, Bloom SR (1982) Feeding and the development of enteroinsular hormone secretion in the preterm infant: effects of continuous gastric infusions of human milk compared with intermittent boluses. Acta Paediatr Scand 71(3):379–83
doi: 10.1111/j.1651-2227.1982.tb09438.x
pubmed: 6814175
Corvaglia L, Martini S, Battistini B, Rucci P, Aceti A, Faldella G (2014) Bolus vs. continuous feeding: effects on splanchnic and cerebral tissue oxygenation in healthy preterm infants. Pediatr Res 76(1):81–5
doi: 10.1038/pr.2014.52
pubmed: 24713819
Martini S, Frabboni G, Rucci P, Czosnyka M, Smielewski P, Galletti S, Cimatti AG, Faldella G, Corvaglia L, Austin T (2020) Cardiovascular and cerebrovascular responses to cardio-respiratory events in preterm infants during the transitional period. J Physiol 598(18):4107–4119
Dollberg S, Kuint J, Mazkereth R, Mimouni FB (2000) Feeding tolerance in preterm infants: randomized trial of bolus and continuous feeding. J Am Coll Nutr 19(6):797–800.
doi: 10.1080/07315724.2000.10718080
pubmed: 11194534
de Ville K, Knapp E, Al-Tawil Y, Berseth LZ (1998) Slow infusion feedings enhance duodenal motor responses and gastric emptying in preterm infants. Am J Clin Nutr 68(1):103–8
doi: 10.1093/ajcn/68.1.103
pubmed: 9665103
Parker P, Stroop S, Greene H (1981) A controlled comparison of continuous versus intermittent feeding in the treatment of infants with intestinal disease. J Pediatr 99(3):360–4
doi: 10.1016/S0022-3476(81)80318-6
pubmed: 6790688
Chowdhury AH, Murray K, Hoad CL, Costigan C, Marciani L, Macdonald IA, Bowling TE, Lobo DN (2016) Effects of Bolus and Continuous Nasogastric Feeding on Gastric Emptying, Small Bowel Water Content, Superior Mesenteric Artery Blood Flow, and Plasma Hormone Concentrations in Healthy Adults: A Randomized Crossover Study. Ann Surg 263(3):450–7
doi: 10.1097/SLA.0000000000001110
pubmed: 25549202
Baker JH, Berseth CL (1997) Duodenal motor responses in preterm infants fed formula with varying concentrations and rates of infusion. Pediatr Res 42(5):618–22
doi: 10.1203/00006450-199711000-00012
pubmed: 9357934
Bowling TE, Cliff B, Wright JW, Blackshaw PE, Perkins AC, Lobo DN (2008) The effects of bolus and continuous nasogastric feeding on gastro-oesophageal reflux and gastric emptying in healthy volunteers: a randomised three-way crossover pilot study. Clin Nutr 27(4):608–13
doi: 10.1016/j.clnu.2008.04.003
pubmed: 18513835
Jadcherla SR, Chan CY, Moore R, Malkar M, Timan CJ, Valentine CJ (2012) Impact of feeding strategies on the frequency and clearance of acid and nonacid gastroesophageal reflux events in dysphagic neonates. JPEN J Parenter Enteral Nutr 36(4):449–55
doi: 10.1177/0148607111415980
pubmed: 22038208
Kumar V, Thakur A, Garg P, Kler N (2024) Comparison of Three Modalities of Feeding in Preterm Infants ≤32 Weeks and ≤1,250 G: A Randomized Controlled Trial. Am J Perinatol 41(S 01):e1792–e1799.
Rövekamp-Abels LW, Hogewind-Schoonenboom JE, de Wijs-Meijler DP, Maduro MD, Jansen-van der Weide MC, van Goudoever JB, Hulst JM (2015) Intermittent Bolus or Semicontinuous Feeding for Preterm Infants? J Pediatr Gastroenterol Nutr 61(6):659–64
doi: 10.1097/MPG.0000000000000888
pubmed: 26595853
Silvestre MA, Morbach CA, Brans YW, Shankaran S (1996) A prospective randomized trial comparing continuous versus intermittent feeding methods in very low birth weight neonates. J Pediatr 128(6):748–52
Ashby DW, Anderson J, Peaston MJ (1963) Haemorrhage from peptic ulcer treated by continuous intragastric milk drip and early generous feeding. Gut 4:344–8
doi: 10.1136/gut.4.4.344
pubmed: 14084744
pmcid: 1413487
Doll R, Price AV, Pygott F, Sanderson PH (1956) Continuous intragastric milk drip in treatment of uncomplicated gastric ulcer. Lancet 270:70–3
doi: 10.1016/S0140-6736(56)92128-6
pubmed: 13287059
López-Alonso M et al (2006) Twenty-four-hour esophageal impedance-pH monitoring in healthy preterm neonates: rate and characteristics of acid, weakly acidic, and weakly alkaline gastroesophageal reflux. Pediatrics 118:e299-308
doi: 10.1542/peds.2005-3140
pubmed: 16831894
Corvaglia L et al (2011) The frequency of apneas in very preterm infants is increased after non-acid gastro-esophageal reflux. Neurogastroenterol Motil 23(303–7):e152
pubmed: 21175996
Corvaglia L et al (2014) Cardiorespiratory events with bolus versus continuous enteral feeding in healthy preterm infants. J Pediatr 165:1255–7
doi: 10.1016/j.jpeds.2014.07.043
pubmed: 25171852
Cooke RJ, Embleton ND (2000) Feeding issues in preterm infants. Arch Dis Child Fetal Neonatal Ed 83:F215-8
doi: 10.1136/fn.83.3.F215
pubmed: 11040172
pmcid: 1721167